Hippocrates Choice

There is no relationship like the patient-physician relationship and no profession like that of a physician. The parent-child relationship comes the closest.

I marveled at the Independence Day beach goers, patriotism radiating from the multitudes of my fellow starred and striped T-shirt wearing, Old Glory/ Come and Take It flag-waving Texans. I praised God for all his Truth and splendor in the moment. I reflected on those who forged this great nation of the most liberated, innovative, and Godly people in world history. Then I thanked God for his instruments, the physicians, without whom I would not be a participant in this joyous celebration.

From my ankles to my eyes, my womb to my breasts, my brilliant, brave surgeons fixed me when I was broken and rebuilt me to walk, see, give birth, survive cancer, and march physically pain free through the July 4th waves of glory in a red, white, and blue two-piece swim suit- my external scars, invisible to the unsuspecting passerby. I knew many fellow revelers, like me, were served by great physicians and surgeons; you see, several were my very own patients. Through all my annoying healthcare issues, thanks to my physicians, the most time I ever missed from my practice was two weeks. I humbly serve thousands. My patients are so precious to me – and so is time.

Not with me on the beach was my oldest daughter. Born via an emergency C-section when I was a resident, the precious young physician, a 4.0, hard-working, compassionate servant of God and man, was working, “on-call” at the VA hospital. It was the first week of her internship. She was humbly serving our bravest. She will save and serve thousands.

She had just shared with me her latest revelation, “What they don’t tell you in med school is about the overwhelming, profound, indescribable sense of responsibility, devotion, and love you have for your patients.” “So, now you know,” I said. “That can’t be taught,” I thought. We now shared the rare “knowing”.

Also missing was my father. Born into poverty, the esteemed pioneering neurosurgeon overcame adversity through hard work and education, to found a neurosurgery residency training program and neuroscience program responsible for significant advances in neurosurgery. He saved and served thousands.

While retired “on paper”, he keeps his medical license active, attends medical meetings, and never leaves home without his stethoscope the consummate physician and community servant-always prepared for the curbside consult. We share the profound, rare knowing.

I’m the middle generation physician. I see what was, what is, and what will be if my colleagues and I do nothing and, in our inaction, facilitate the demise of once-exceptional, American medicine.

I went into medicine aspiring to achieve the greatness of my father by doing what he did. In my father’s words, a physician must: “Honor the tradition, serve the sick, and advance the field.”

I am a Hippocratic physician. I do my best to serve my patients to the best of my ability through a private, personal, sanctified, dignified relationship. Only those of us who have traversed the Rite of Passage to become a physician understand what this means. There are no words to convey this understanding.

My ability to freely engage my patients and their families and practice Hippocratic medicine unadulterated by power-seeking, over bearing government policymakers and money-seeking hospital and insurance company profiteers is of utmost importance to me. A physician’s goal is the well-being, best interest, and best individual outcome for each unique patient- not power and money. Yes, we need money from our work to support our families and to afford the privilege of practicing our profession, but, unlike for government, lobbyists, insurance companies, and hospitals- money and power are not the physician’s motivating forces.

Enter Obamacare. The American Nightmare of a healthcare law intentionally demonized and restricts physicians and strategically undermines Hippocratic medicine to transform the blessings of liberty for each individual American to a compulsion to serve the state for the common good. Obamacare seeks to sever the patient-physician relationship and replace it with the government- subject relationship.

The goal of transferring money and power to government, hospitals, and insurance companies has supplanted the goals of the patient-physician relationship. Patient care is violated. Innovation is squelched. Medical education is hijacked. Absurd rules, manipulative regulations, perverse incentives, and meaningless “quality indicators” replace common sense, sanity, morality, and humanity itself. Government seeks to be God. To survive, physicians must play this deadly game. The only way not to lose is not to play- or worse, to lie.

Will physicians lie in order to continue to be able to practice medicine and actually take care of patients under government-run medicine? If physicians lie, on seemingly small things at first, what will we not lie about, and when, if ever, will we stop lying? We are on the sled atop a truly life and death slippery slope.

While we are not all physicians, we are all patients. I contend that those who profess to love and support Obamacare have either never needed actual medical treatment or have been preferentially exempted from its clutches.

Under the auspices of Obamacare, is one big continuous lie OK?

No. The big lie is not OK.

Rather than fudging and lying on computerized data collection forms, and so on, to survive under an oppressive law, cowering in fear of retaliation and loss of profession, the physician must seek and state only truth and call out the false premises built into the law and upon which the law was built.

Physicians who play the lying game feed the “Garbage in-Garbage Out” machine and will be responsible for destructive, morbid, if not lethal, healthcare policy resulting from Obamacare.

Physicians who refuse to lie and play the game will no doubt suffer; they will face defamation of character, restraint of trade, loss of licensure, loss of patients, loss of hospital privileges, loss of insurance contracts, RAC audits, IRS targeting, potential bankruptcy, and even imprisonment. But, ultimately, the law will crumble when it is exposed in stark naked, Truth.

As my father’s daughter, my physicians’ patient, and my patients’ physician, this pursuit of truth and defense of Hippocratic medicine is my mission, my calling. I will sacrifice it all, to my last breath, for such truth.

As my physician-daughters’ mother, this is a more difficult choice. Could government, institutes of medical education, certification, licensure, hospital, and/or insurance company retaliation be directed at my precious self-sacrificing children because of my resistance? I admit; I fear this.

Knowing what I know, should I bite my tongue and go along in a safer silence, or should I take the risk and speak out? What would Hippocrates do?Kris Held MD is an ophthalmologist in private practice. You can follow Dr. Held on Twitter @kksheld

Comments

The fact that you fear to dissent speaks volumes.We did not need a bureaucratic layer imposed between us and our patients.This benefits no one but the government.It very definiteley does not benefit patients.As a matter of fact,I have been asked to lie recently when renewing CMNs.I have however refused to sign these documents if the information on them does not accurately reflect my examination findings.I also no longer refer to Hospice anymore,since it is euthanasia now,not palliation.Acceleration of death is murder,not patient care.
We as physicians have always been held to a higher moral standard.We should not abandon that stance for a bureaucracy that is amoral and soulless.

Thank you for standing for truth, Larry. I, like you, refuse to play the game. I concur with your assessment of palliative care with reference to the ACA and its operatives’ philosophy. It is alarming how much in Obamacare relates to “pain management…” Medical care is becoming “The Long Goodbye.” Take your morphine, and check out quietly- but don’t forget to submit your “data”, so money can be laundered to someone…

Hello middle generation physician from another old-timer of probably the same ilk as your father. I too am retired but medicine is in my bones,so I and our team at Healthy.CoOp are working to change the future of healthcare.Please visit us on Indiegogo where we have just launched our start up campaign. http://www.indiegogo.com/projects/healthy-coop-startup-campaign/x/7917568 Despair not. Continue to hold your head up high. As we were used to say in South Africa…. don’t let the bastards grind you down. We need many more like you. My photography (passion) website is where I wallow when I am down. You might find it of interest. Feel free to wallow with me.